N. Drabińska-Fois, AM. Ogrodowczyk, W. Bauer, J. Topolska, N. Bączek, V. Stenbäck, KH. Herzig, S. Borowicz-Skoneczny, et al. (2026). Immune-modulating effects of energy-restricted ketogenic diet in women with overweight and obesity: KETO-MINOX study. European journal of nutrition, 65(3). https://doi.org/10.1007/s00394-026-03935-7

PubMed 41793518

[Abstract]
PURPOSE: The ketogenic diet (KD) is widely applied to manage obesity, however, their immunological effects under moderate, standardized caloric restriction and their persistence after intervention remain insufficiently characterized in individuals with obesity. This study aimed to evaluate the effect of an 8-week, isocaloric, energy-restricted Mediterranean-type KD on body composition and cytokine profiles in women with overweight and class I obesity. Observational long-term outcomes were assessed one year post-intervention. METHODS: Eighty women (BMI 25.5–34.9 kg/m2) without chronic diseases were randomized to either a KD (KETO group) or a standard diet (STD group), both providing 1750 kcal/day. Assessments were conducted at baseline (T0), 4 weeks (T1), 8 weeks (T2), and one year post-intervention (T3). Body composition and inflammatory markers were measured after overnight fasting. RESULTS: Sixty-six participants completed the intervention, and 49 returned for the T3 follow‑up. The adaptation to ketosis was confirmed in the KETO group around fourth week. Both diets significantly improved body composition and reduced inflammatory markers. Compared with the STD group, the KETO group achieved greater reductions in body weight, total fat mass, and truncal fat. The KD was also associated with significant short‑term modulation of specific cytokines, including interleukin‑5 (IL‑5), granulocyte‑macrophage colony‑stimulating factor (GM‑CSF), interleukin‑8 (IL‑8), and monocyte chemoattractant protein‑1 (MCP‑1). At T3, no significant long-term differences in body composition or inflammation were found, except for an increase in IL-10 in the KETO group. CONCLUSIONS: In summary, the findings indicate that the effectiveness of dietary interventions is more strongly influenced by participant adherence than by the specific macronutrient composition, as both dietary approaches resulted in significant weight loss and reductions in inflammation-related biomarkers. While the Mediterranean‑type KD induced greater short‑term fat loss and selective cytokine modulation, these advantages did not translate into sustained long‑term differences. Clinical Trial Registry number NCT05652972 ( https://clinicaltrials.gov/study/NCT05652972 ).